What causes pain under your cheekbones

Cheek pain, pain in the cheek

Triggers and therapy for sore cheeks

Cheek pain can have a variety of causes. They are often due to irritation or inflammation of the facial nerves (neuralgia). The most common area of ​​the face is trigeminal neuralgia, where the pain originates from the fifth cranial nerve, the trigeminal nerve. It runs in three main branches on the face and can cause very severe pain.

However, the masticatory muscles, the temporomandibular joint or foci of inflammation in the teeth are also often the trigger for pain in the cheek. In addition, there are fractures and bruises that can be traced back to accidents. In order to be able to start a targeted therapy, it is first necessary to find the exact cause of the symptoms.

Definition

Pain in the face below the eye socket, between the cheekbone and lower jaw is called cheek pain. The complaints can occur selectively or extensively, acutely or chronically. Facial pain in the cheek area that can be traced back to trigeminal neuralgia is one of the most severe pain experiences.

Cheek pain with neuralgia

Cheek pain can occur selectively regardless of movement and position, in small areas but also depending on movements of the temporomandibular joint, so that the symptoms can be felt when opening or closing the mouth. They can also make themselves felt at certain points in front of the temporomandibular joint or along the zygomatic bone.

There are some nerves and muscles running around the cheeks that can cause severe pain due to irritation and inflammation. The medical term for nerve pain is neuralgia. This includes pain that is felt in the supply area of ​​one or more nerves and is caused by damage to these peripheral nerves.

Trigeminal neuralgia is one of the most common neuralgias. The facial nerve, the trigeminal nerve, which runs in three main branches in the face, is the cause of the pain. One of these nerve branches (maxillary nerve) runs into the cheek area. More precisely, the pain trigger is the infraorbital nerve. It supplies the teeth of the upper jaw and the skin of the front and upper face and emerges through a hole in the upper jaw (foramen infraorbitale) about three millimeters below the eye.

The trigeminal nerve supplies the individual facial areas with sensitivity on the one hand, but is also responsible for the activity of the chewing and temple muscles. This nerve can be irritated, for example, if an adjacent blood vessel in the lower part of the brain changes or other parts of the trigeminal nerve are pinched off. Sometimes the cause cannot be conclusively clarified. In other cases, the pain may be triggered by another underlying disease, such as multiple sclerosis or a tumor. Accident head injuries can also lead to nerve pain.

Symptoms of trigeminal neuralgia include sudden, stabbing pain, especially superficial on the cheek and chin, which can also trigger toothache. The pain attacks often only last a few seconds and are repeated at short intervals. This is usually followed by a phase without attacks until the pain starts again.

Another cause of cheek discomfort can be a herpes zoster (herpes zoster). A weakened immune system, for example in older people, is often the reason why the chickenpox virus breaks out again and causes acute and chronic complaints. The extremely unpleasant neuralgia is called post-therapeutic zoster neuralgia.

Cheek pain in craniomandibular dysfunction

Craniomandibular dysfunction refers to complaints of the masticatory muscles and the temporomandibular joint. The pain that occurs is often localized in the area of ​​the cheeks or radiates there. The muscles that are responsible for closing the mouth are usually very tense and can cause pain.

According to recent studies, these muscles have a changed pH value as well as increased values ​​for pain substances, which could be partly responsible for the development of pain. In addition, clenching or rubbing your teeth during the day or grinding your teeth at night could lead to muscle hardening. Asymmetries of the temporomandibular joint, which are caused, for example, by misaligned teeth or tooth growth, lead to uneven stress on the muscles and could cause one-sided complaints. In addition, the teeth themselves can cause discomfort, as with foci of inflammation.

Pain in the cheek with underlying diseases

Pain in the cheek area sometimes occurs as a result of other conditions. For example, sinus infections, tooth and jaw problems, problems in the cervical spine and muscle tension in the shoulder and neck area are possible. In most cases, other specific symptoms appear on the surface. Then cheek pain is only a side effect.

In addition, there are numerous diseases that affect the head or the inside of the skull. Strokes and brain tumors are one example. Even with migraines, some of the pain radiates into the cheeks. In diseases that affect the central nervous system such as multiple sclerosis, cheek discomfort can also occur in addition to other symptoms.

The causes mentioned here are only a selection and are not suitable for self-diagnosis. A doctor should be consulted in the event of cheek pain that occurs suddenly and violently, persistently or repeatedly, or after an accident.

diagnosis

In order to track down the cause of the symptoms, the doctor will first clarify when and where exactly these occur. Other symptoms can also indicate an underlying disease. If the pain in the cheek occurs suddenly or as a result of a certain stimulus such as brushing your teeth or stressful situations, this can indicate trigeminal neuralgia. If those affected feel the discomfort especially when chewing, it is likely that there is a problem with the teeth or the temporomandibular joint.

In addition to palpating the cheek area, other examinations such as x-rays and MRIs may be necessary. Depending on the cause, doctors from various specialties such as dentists, orthodontists, ear, nose and throat specialists, orthopedists, neurologists and internists are consulted.

Treatment options for cheek pain

Therapy for cheek pain depends on its cause. In the case of a malfunction in the temporomandibular joint (CMD), a special bite splint or small corrections of the bite position in conjunction with appropriate exercises are often sufficient to alleviate the symptoms. More complex interventions are usually only carried out if all other measures have been exhausted or only such an intervention can resolve the dysfunction.

If muscle tension is the trigger, physical therapy, manual therapy, and muscle relaxation techniques can provide relief. There is also the option of electrical nerve stimulation through the skin to relax the muscles.

Medication is usually used for nerve pain such as trigeminal neuralgia, provided there is no underlying disease. Since pain relievers are not effective in relapsing pain attacks, those affected are often given so-called anti-epileptic drugs, which are mainly used in the treatment of epilepsy and prevent attacks of pain by influencing the excitability and conductivity of the nerve tracts. In severe cases, an operation can also be useful, in which the relief of the irritated or pressurized nerve or the interruption of the pain path is the main focus.

Surgical interventions may also be necessary for tumors, fractures, or sometimes multiple sclerosis.

Natural Remedies for Cheek Pain

The treatment concept of osteopathy, which was founded by the American doctor Arthur Taylor Still, includes further factors and relationships in the diagnosis that can influence the cheek area, but are often not taken into account in conventional medicine. As part of the initial examination, complaints such as neck tension, temple pain, forehead pain or hip pain are included and, if necessary, treated. This is useful because they influence the overall statics of the body.

Depending on the cause, natural remedies can also be used, which are used either in addition to or as an alternative to conventional medicine. For example, cloves have been used as a tried and tested home remedy for toothache for centuries, as their ingredients have an analgesic effect. In addition, they should have an antiviral effect and, in particular, against herpes viruses.

If the cheek pain is due to an inflammation in the mouth, you can gargle with chamomile or sage, as both are said to have anti-inflammatory effects. (no, last updated on 7.3.2018)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.

Dipl. Social Science Nina Reese
  • Daniel R. Reissmann: Therapy of craniomandibular dysfunctions, dentistry up2date 2017; 11 (02): 179-202, DOI: 10.1055 / s-0042-116618, Georg Thieme Verlag, (accessed on August 28, 2019), thieme
  • Kenneth M. Kaye: Herpes zoster (shingles; acute posterior ganglionitis), MSD Manual, (accessed on August 28, 2019), MSD
  • Thomas Lenarz, Hans-Georg Boenninghaus: ENT, Springer-Verlag, 14th edition 2012

Important NOTE:
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.